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The concept of embedding researchers into policy and other settings is gaining traction as a way to enhance the role of research evidence in informing decision-making. A new EPPI Centre project explores the influence that 'embedded researcher' interventions could have in public health decision-making (see project page here). Embedded researcher interventions may be potentially useful in helping public health organisations to become more research active as they are challenged by widening health inequalities from COVID-19 and budget constraints. Early on in the project we have been confronted with a thorny issue – exactly what is an ‘embedded researcher’? In this blog Dylan Kneale, Sarah Lester, Claire Stansfield and James Thomas discuss this challenge and why researching this ‘intervention’ is important, and we are interested in your feedback on this.

 

By Dylan Kneale, Sarah Lester, Claire Stansfield and James Thomas.

Introduction

Embedding researchers into policy and other settings is thought to be a way of enhancing research capacity within organisations to enable them to become more involved in the research process either as consumers, generators, commissioners, influencers, stakeholders or a mixture of these roles. The literature suggests that research evidence could have a more prominent role in public health decision-making than is currently the case1 2. In our project, we view embedded researchers as potential disruptors of organisational cultures, who can enable organisations to become more active through occupying roles as mobilisers or (co)producers of research, or facilitators of research use. Embedded researchers could address these issues in a number of ways including through (i) actively researching and contributing to decision-making processes; (ii) changing cultures around research engagement, including the indirect or diffuse influence of research (enlightenment), direct research utilisation (instrumental usage), or research generation; and (iii) helping to produce research evidence that matches the need of decision-makers with regards to the research questions asked and their contextual salience. Part of our project involves systematically identifying research evaluations of embedded research across a range of policy, industry and commercial settings in order to produce a systematic map and a systematic review. Developing a set of principles to define an embedded researcher is crucial to this goal, as existing definitions of embedded research do not fully capture what we are seeking to achieve.

Existing definitions of embedded researcher

Embedded researchers within local public health decision-making contexts have previously been defined as those ‘researchers who work inside host organisations as members of staff, while also maintaining an affiliation with an academic institution’3. McGinty and Salokangas (2014)4 define embedded researchers as: “individuals or teams who are either university-based or employed undertaking explicit research roles […] legitimated by staff status or membership with the purpose of identifying and implementing a collaborative research agenda.” Meanwhile they define embedded research  as: “a mutually beneficial relationship between academics and their host organizations whether they are public, private or third sector” (McGinity & Salokangas, 2014, p.3). While these definitions are unproblematic in many ways, the extent to which this definition captures the plurality of models of embedded research is unclear, and the extent to which some of the models of placement where researchers may not feel they have, or may not be recognised as having, dual affiliation is unknown. This is of significance for our systematic map and review. For example if applied literally, the first definition may serve to omit forms of embedded research activity undertaken by researchers who may be based in a host (non-academic) organisation but may not be considered ‘staff’ (e.g. PhD students); meanwhile the second definition, if applied literally, could lead to very short term activities such as delivering research training, being in scope. These ambiguities appear to suggest that ‘embedded researcher’ appears as a concept that we may know when we see it, although is challenging to define precisely.

Why is defining an embedded researcher so challenging?

Some of the reasons why defining embedded researchers is so challenging include:

  • Terminology: Embedded researchers, researchers-in-residence, seconded researchers, policy-fellows, embedded knowledge mobilisers, and several other terms appear to be aligned with the focus of our project.
  • Intervention complexity: While embedded research activities are rarely broken down into intervention ‘components’ per se (an aim of our project), we would nevertheless expect that an embedded researcher intervention would have several interacting ‘components’, with change occurring in non-linear ways that are manifested across different organisational roles and levels, and that there would be a high degree of tailoring across embedded researcher ‘interventions’ 5; these properties are synonymous with intervention complexity.
  • Fuzziness: Not only is an ‘embedded researcher’ a fuzzy concept in itself; it is also predicated and defined through a number of other fuzzy concepts (e.g. ‘research-active’, ‘organisational change’, ‘research skills’ etc.) each of which is open to interpretation.
  • Patterns of evaluation: Although embedded research activities have a long tradition, our initial assessment of the literature suggests that these interventions tend to be evaluated through self-reflection and descriptive case studies. Although these are useful, richer evaluation data being made available would help to understand impacts of embedded researchers.
  • Non-manualised: Related to the points above, embedded research ‘interventions’ tend to take place without any form of ‘manual’ or ‘handbook’ on how the intervention should be conducted.

Towards a set of principles defining embedded research activity

Rather than a crisp neat definition, embedded research activity may instead be more usefully defined through a set of principles. With the input of our steering group, we view embedded researchers as being defined by the following principles:

(i) they enable research activity and research use. For example, they may undertake research, facilitate the conduct of research (through sourcing data, creating data sharing arrangements or advising on research processes), and support research use;
(ii) they are co-located in a defined policy, practice or commercial formal organisation;
(iii) they are situated within a host team (physically or institutionally or affiliation or culturally) and/or are expected to work within the host team culture for a high proportion of their time as a team member working on and solving practical problems;
(iv) they have an affiliation with an academic institution or research organization, or their post is specifically funded by an academic institution or research organization;
 (v) these activities entail continued engagement with a host team (i.e., an embedded researcher is more than a notional job title but a different way of working for researchers);
(vi) the relational nature of embedded research necessitates that this is a long-term activity (i.e., unlikely to be possible in less than a month);
(vii) we expect that host organisations will be able to influence and direct the work of embedded researchers (i.e., embedded researcher activities are generally distinct from, for example, an ethnographic study of policy-making in an organization);
(viii) we view embedded researchers as contributing pre-existing skills and experience to the host organization, and not developing these skills on-the-job and therefore we do not view taught degree placements as examples of embedded researcher activities;
finally, and crucially (ix) we view embedded researchers as exemplifying a two-way relationship where there is learning to be gained for both embedded researchers and their host organisations. Our definition also leaves open the possibility of bi-directionality in that researchers could be embedded into policy/practice settings and that those from policy/practice settings could be embedded into research organisations (provided they meet the other principles).

Why is studying embedded researcher activity important?

Embedded researchers may be in a pivotal position to actively span boundaries between policy organisations and research organisations. This may be important as we emerge from a period where Local Authority public health teams are being asked to do more with less, having been besieged by cuts to budgets pre-dating the COVID-19 pandemic6, and where public health systems have been under massive strain during the current pandemic. Our research is also taking place in the context of new proposed changes in health systems and delivery structures with a focus on further integration of public health, ‘clinical’ health (NHS), and social care (among other proposed changes7), and further changes in the organisational structure of public health and the abolishment of Public Health England8, requiring greater consideration of the role of embedded researchers within integrated teams.
As a team we are also interested in whether embedded researcher interventions can help to address an emerging gulf in terms of health inequalities. While our understanding of the extent and nature of health inequalities appears to be increasing, this understanding has generally not (i) mitigated the increasing gap in health outcomes between different social groups; or (ii) kept pace with our understanding of if/how health inequalities can be addressed at the local level. We are interested if embedded researchers help to address these gaps and how.

Why have we written this blog?

If you’ve read this blog to this point – thank you! – and our intention in writing this blog is to reach out to ask for your input in the early days of this project. Please get in touch with us (email D.Kneale@ucl.ac.uk) if you would like to help in any of the following ways:

  • Comment! Let us know what you think of our definition of embedded researchers
  • Alert us! Let us know if you have any studies that you think should be included in a review of embedded researcher activity, or if you are working on relevant research in this area.
  • Get involved! We are currently scoping out an evaluation study of embedded research activity. If you are working as an embedded researcher in public health, or are planning to do so, please let us know. We would love to talk to you about this.

References

1. Kneale D, Rojas-García A, Raine R, et al (2017). The use of evidence in English local public health decision-making. Implementation Science, 12(1):53.
2. Orton L, Lloyd-Williams F, Taylor-Robinson D, et al (2011). The use of research evidence in public health decision making processes: systematic review. PloS One, 6(7):e21704.
3. Vindrola-Padros C, Pape T, Utley M, et al. (2017) The role of embedded research in quality improvement: a narrative review. BMJ Quality and Safety, 26(1):70-80.
4. McGinity R, Salokangas M (2014) Introduction:‘embedded research’as an approach into academia for emerging researchers. Management in Education 28(1):3-5.
5. Thomas J, Petticrew M, Noyes J, et al. (2019) Chapter 17: Intervention complexity. In: Cochrane Handbook for Systematic Reviews of Interventions (2nd ed) Chichester (UK): John Wiley & Sons.
6. Iacobucci G (2016) Public health—the frontline cuts begin. BMJ, 352.
7. Iacobucci G (2021) Government to reverse Lansley reforms in major NHS shake up: British Medical Journal Publishing Group.
8. Vize R (2020) Controversial from creation to disbanding, via e-cigarettes and alcohol: an obituary of Public Health England. BMJ 371.

 

 

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